Time to talk openly about death and dying
The AMA joins with Palliative Care Australia to urge Australians to be more open within families and the broader community about death and dying, and discuss formerly taboo issues such as end of life care, during National Palliative Care Week, which commences today.
The theme of National Palliative Care Week, 24-30 May 2015, is 'Dying to talk; talking about dying won't kill you'.
AMA Vice President, Dr Stephen Parnis, said today that the AMA encourages people to reflect on, and discuss, death and dying with their loved ones and with their doctor before a health crisis happens.
“Discussing death is profoundly confronting, but it's important to talk with family and loved ones about how, and where, you would like to be cared for at the end of life,” Dr Parnis said.
“It is important that people have their wishes fulfilled as they approach the end of their lives, but that does not often happen.
“While 70 per cent of Australians would prefer to receive more palliative care and die at home, only one in seven actually get that wish,” Dr Parnis said.
The AMA strongly encourages everyone to consider advance care planning, a process by which an individual provides preferences about health and personal care, including preferred health outcomes, goals and values of care which can guide treatment decisions, and who they would like to make decisions for them should they lose decision-making capacity in the future.
Dr Parnis said advance care planning can be part of a health care discussion with patients of all ages within the primary care environment or hospital setting.
“The process respects the patient's right to take an active role in their health care in an environment of shared decision-making between the patient and their doctor,” Dr Parnis said.
“This process can involve family members and carers, where appropriate.
“The advance care planning process is ongoing, which is important as an individual's preferences and goals of care may change if they get diagnosed with a life-limiting condition, and as that condition progresses.
“Doctors, particularly General Practitioners, play an important role in supporting patients, in a culturally appropriate manner, to discuss death and dying and to make an advance care plan.
“Doctors can provide information about the clinical aspects of care, and help answer any questions, including those related to palliative care.
“Patients with limited, or fluctuating, decision-making capacity should be encouraged and supported to discuss their values and goals of care, including treatment options, consistent with their level of capacity.
“Support should be provided for children and young people facing life-limiting conditions, consistent with their capacity, and mental and emotional maturity.”
The AMA believes that medical education should include relevant resources and programs to provide the knowledge and skills to provide safe, competent and effective care to support patients and their families at the end of life. This includes identifying when a patient may benefit from palliative care.
“Palliative care is needed within the community, and all the way through emergency and intensive care,” Dr Parnis said.
“Doctors and patients need to be better informed about accessing palliative care services and resources.
“Families need to know what support is available, such as respite care, nursing care, and community services, particularly if they are caring for a dying person at home.
“And a well-distributed, accessible, and appropriately trained and skilled specialist and primary health workforce is required to meet the needs of people at the end of life.
“We need greater community awareness and education about end of life care, including information about palliative care and advance care planning.
“Most of all, we need to get more and more people talking about death and dying and respecting the end of life wishes of family and loved ones,” Dr Parnis said.
More information on National Palliative Care Week is available at http://www.palliativecare.org.au/
The AMA Position Statement on End of Life Care and Advance Care Planning 2014 is at https://ama.com.au/position-statement/end-life-care-and-advance-care-planning-2014
24 May 2015